Support is requested for continuation of our research training in Geriatric medicine program at Case Western Reserve University (CWRU) and its affiliated teaching hospitals-University Hospitals of Cleveland (UHC) and the Cleveland VA Medical Center (CVAMC). The goal of the program is to prepare physician trainees as independent investigators in aging research at academic institutions. This is accomplished through a year of clinical geriatric medicine (supported locally), followed by two years of NIA- supported intensive didactic and experiential research training. Strong collegial relationships among basic and clinical investigators at CWRU, has stimulated innovative joint programs leading to dual certification in geriatric medicine and other subspecialties and opportunities to obtain an advanced degree. Twenty-three research sponsors offer training in five coordinated cores: l) Geriatric Health Care Delivery; 2) Cellular Aging and Metabolism; 3) Musculoskeletal Aging; 4) Aging of the Nervous System; and 5) Cardiopulmonary Physiology. Five of the seven fellows in our initial funding cycle (1987-91) have received major federal grant support after completion of their fellowships. Eight fellows have been enrolled in the current grant cycle (1991-96), with three trainees scheduled to begin in July 1995. All of the fellows completing the NIA program since its inception hold medical school faculty appointments. During this grant cycle, a joint training program in clinical research and epidemiology was instituted with the Dept. of Medicine Program in Health Care Research, supported in part by the CWRU Claude Pepper OAIC, with the collaboration of the Dept. of Epidemiology and Biostatistics. Parallel training tracks with overlapping core didactic and clinical activities will be created for trainees involved in clinical and basic biomedical research with common cores of didactic and clinical activities. These include lectures, seminars and journal clubs in clinical geriatrics, biology and psychology of aging, long term care, ethics, health care policy issues, and skills development in teaching and administration. Clinical training involves block and longitudinal experiences in ambulatory assessment units, inpatient assessment, acute geriatric care and long term care facilities, supervised by full time and affiliated geriatric medicine faculty. Research directed activities in the initial clinical year is comprised of core seminars on epidemiology and biostatistics, exploration of research opportunities, development of an individualized curriculum, and preparation of a research proposal. The latter two years involve supervised research, supplemented with coursework, research presentations and related didactic activity. Fellows in the clinical research track are enrolled in the Joint Training Program in Health Care Research, which offers intensive training in clinical epidemiology, clinical decision sciences, statistical analysis and health services research. Fellows in the basic science track can choose from offerings by experienced scientists and training program directors. Criteria for research independence includes acceptance of findings in peer-reviewed journals, presentation of data at national meetings and preparation of an NIH-type research proposal. Preference for admission is given to physicians seeking academic careers, who have completed residency training in Medicine, Family Medicine, Neurology and Psychiatry. This program has attracted superior postdoctoral trainees to aging research, stimulated collaborative efforts in aging research, increased our faculty pool and heightened visibility of geriatrics and gerontologic research at CWRU.